SearchIdaho222Q00000X

Andrea Russell

NPI 1770342420 · on the registry since 2024 · sole proprietor

Practice

Address
1200 Jaylee Dr Unit 1
Rigby, ID 83442
Phone
(208) 419-9383
Organisation at this address
Andrea Russell
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
222Q00000X
222Q00000X
Also registered as
251S00000X
Sex
Female
Record last updated
2026-04-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho